SCI impairments

9 main impairments common in SCI

spinal shock, cardiovascular impairment, autonomic dysreflexia, bowel and bladder, motor and sensoey, pain, spastic hypertonia, impaired thermoregulaiton, sexual dysfunciton

spinal shock: a period of ____ following sci

areflexia

spinal shock: ____ to lesion - spinal ____, _____ and ___ function, and ____ control are absent or depressed

caudal, reflexes, voluntary motor, sensory, autonomic

phase 1 of spinal shock = _____

• timeframe ____-___

total areflexia, day 0-1

phase 2 of spinal shock = _____

• timeframe ____-____

initial return of some reflexes, day 1-3

phase 3 of spinal shock = ____

• timeframe ____-____

return of reflexes and early hyper-reflexia, week 1-4

phase 4 of spinal shock = _____

• timeframe ____-____

spasticity and hyperreflexia, month 1-12

____ is in thoracic region, if injury, can cause major disruption

sympathetic trunk

SCI blocks communication between ____ and ____

• intact _____ to the heart (____, _____)

• impaired _____ to the heart and periphery (_____, _____)

brainstem, thoracic cord, parasympathetic, bradycardia, bradyarrythimas, sympathetic, hypotension, orthostatic hypotension

as spinal shock resolves, spinal ______ return but lack of _____ influences. _____/____ reminds

• reduced ____ tolerance

• exercise-induced _____

• reduction in ____ return, ____ and _____

• ______

sympathetic reflexes, supraspinal, parasympathetic, sympathetic, exercise, hypotension, venous, SV, CO, autonomic dysreflexia

autonomic dysreflexia: exaggerated ____ response to ____ stimulation (typically ____), ____ the lesion

sympathetic, sensory, noxious, below

autonomic dysreflexia

• typically lesions above _____

• typically ___ injury

• appears greater than or equal to ____ mo after surgery

T6, complete, 6

s/s of autonomic dysreflexia

• increase of ____ or more compared to ____ normal

• ____ headache

• _____

• ____, ____ and ____ above the leasion

• _____ in head, neck, and upper chest

• ____ deficits

• nasal ____

• _____

• cardiac ____

20 SBP or DBP, post injury normal, bradycardia, flushing, sweating, piloerection, paresthesias, visual, congestion, anxiety, arrhythimas

potential noxious stimuli contributing to autonomic dysreflexia

• ____ issues

• ____ irritation

• _____ injury

• restrictive ____ or _____

• _____

• _____

bladder, bowel, pressure, clothing, shoes, intercourse, menstruation

PT management of autonomuc dysrefleixa

• check _____

• place pt with ____ above the ____

• eliminate _____

BP, head, heart, noxious stimulus

bowel/bladder review

• detrusor mm

  • ____ to empty

  • ____ to fill

• external sphincter

  • ____ to empty

  • ____ to fill

contracts, relaxes, relaxes, contracts

spastic bladder = fails to ____ urine

• hard time ____ bc ____ mm always contracted

store, filling, detrusor

flaccid bladder = fails to ____ urine

• hard time ____ bc ____ mm cant contract

empty, emptying, detrusor

s/s of a UTI

• ______

• increased _____

• _____

• _____

• ____ discomfort

autonomic dysreflexia, spasticity, incontience, fever, abdominal

spastic bowel

• common in level above ____

• reflex defacation = ____

• because ____ and _____ connections from S2 and S4 are intact

S2, occurs, parasympathetic, internal sphincter

flaccid bowel

• common in level ____-____ or ____

• reflex defecation = _____
  because ____ and ____ connections are not intact

S2, S4, cuada, equina, does not, parasympathetic, internal sphincter